Healthcare Provider Details

I. General information

NPI: 1336630037
Provider Name (Legal Business Name): ALEXIS ESTELLE SHERMAN-ROE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 W RIVER ST STE 11A
PROVIDENCE RI
02904-2609
US

IV. Provider business mailing address

15 LA SALLE SQ
PROVIDENCE RI
02903-1814
US

V. Phone/Fax

Practice location:
  • Phone: 401-606-8250
  • Fax: 401-606-1153
Mailing address:
  • Phone: 401-444-6779
  • Fax: 401-444-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD17617
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD17617
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: